OFFICIAL APPLICATION FORM FOR OBTAINING IFMSA-PS FULL MEMBERSHIP

The Palestinian Medical Students Association IFMSA Palestine

Your Full Name Registration Number: University Al-Quds University Al-Najjah University Al-Azhar University Applications to obtain your full membership of IFMSA-PS have to be filled and sent with all the papers required either via e-mail to the Vice President Internal (VPI) or to be handled to the IFMSA-PS General Secretariat Date of obtaining full membership will start when all your papers are complete Questionnaire: 1. In what year are you in your Medical Studies? 2. Expected year of graduation? Your e-mail Address

1st 2nd 3rd 4th 5th 6th .

3. In which committee do you want to register? Standing Committee on Professional Exchange SCOPE ( ) Standing Committee on Medical Education SCOME ( ) Standing Committee on Research Exchange SCORE ( ) Standing Committee on Public Health SCOPH ( ) Standing Committee on Refugees & Human Rights SCORP (( 4. Are you involved in any project of IFMSA Palestine? If yes, what is it? 5. Were you a member in IFMSA Palestine and you want to renew your membership after losing it? 6. If yes in [5]: During what period were you a full member in IFMSA Palestine? 7. If yes in [5]: What was your committee?

[ ]Yes From [

[ ]No ] to [ ]

SCOPE SCORE SCORP SCOME SCOPH

7. If yes in [5]: Describe briefly below what projects or activities have you taken part in? (Any activities/ Exchanges/ Attendance to meetings) & what was your position in that activity? (Coordinator/ Supervisor/ Organizing Committee/ Participant)?

By submitting your application form, you indicate that you agree to the terms and bylaws of IFMSA and IFMSA Palestine and have read and understood them, and will work according to them and will not overstep any of them. Your application is not complete unless you send the following information: a. A filled out Application Form with the date, signed by you. b. A photo copy of your medical student Identity card or any official paper form your university that you are a medical student and your year of medical study. c. Your address and e-mail address (In case any of the above mentioned documents have not been submitted, or the application was not completed this application will be considered invalid) Date: Signature and name of applicant